Deliberate self harm assessment by accident and emergency staff--an intervention study

Area of Science:

• Psychiatry
• Emergency Medicine
• Healthcare Quality Improvement

Background:

• Psychosocial assessment is crucial for patients presenting with deliberate self harm.
• The quality of these assessments in accident and emergency (A&E) departments can vary.
• Targeted training may enhance the skills of A&E staff in conducting these assessments.

Purpose of the Study:

• To evaluate the effect of specific training on the quality of psychosocial assessments for deliberate self harm patients.
• To determine if a brief educational intervention improves A&E staff's approach to these patients.

Main Methods:

• A non-randomized intervention study design was employed.
• Psychosocial assessments of deliberate self harm patients were compared before and after a one-hour training session for A&E nursing and junior medical staff.
• Assessment quality was evaluated by reviewing A&E case notes, with additional examination of hospital parasuicide team records and staff knowledge/attitude surveys.

Main Results:

• The proportion of adequate psychosocial assessments significantly increased from 13% (16/125) before training to 46% (58/127) after training.
• The use of a proforma during assessment was strongly associated with improved quality (52% adequate with proforma vs. 6% without, p < 0.01).
• Communication between A&E staff and the hospital's parasuicide team showed improvement post-intervention.

Conclusions:

• A focused educational intervention for A&E staff can effectively improve the quality of psychosocial assessments for patients with deliberate self harm.
• Implementing standardized tools like proformas is a key strategy for enhancing assessment quality and patient care in emergency settings.